Association between orthodontic treatment and upper airway changes in children assessed with cone-beam computed tomography (CBCT): A systematic review

IF 3.1 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2024-07-08 DOI:10.1111/joor.13797

Yousef Abdalla, Liselotte Sonnesen

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引用次数: 0

Abstract

Background

Some orthodontic devices used in children share similar design principles to appliances used to treat obstructive sleep apnoea in adults. As well as treating malocclusion, orthodontic appliances used in children may therefore also have effects on the upper airway.

Objective

A review of the literature to assess the effects of orthodontic treatment on the upper airway dimensions in children assessed on CBCT.

Materials and Methods

Following registration of the protocol (PROSPERO CRD42023439056), a systematic electronic search of published studies was performed using several databases (PubMed; Scopus, Web of Science and Science Direct) in accordance with the PRISMA guidelines. Inclusion criteria were as follows: age under 18 years, orthodontic treatment with any appliance, a control group who received no treatment or a non-active alternative treatment and airway measurement using CBCT. RoB-2 and ROBINS-I tools were used to assess risk of bias and quality of the evidence.

Results

In total, 341 studies were identified following the initial search. Title and abstract screening resulted in 45 studies for further full-text analysis. On completion of the screening process, a total of 23 studies met the inclusion criteria. Study interventions included functional appliances (10 studies), rapid maxillary expansion (RME) (9 studies), reverse-pull headgear (1 study) and 4 premolar dental extractions (3 studies). The included studies had moderate to high risk of bias, and the quality of evidence was low.

Conclusion

The scientific evidence shows that functional appliances are associated with significant improvements in both upper airway volume and constriction when used in children however, the effects on the nasal cavity are limited. RME was associated with a significant increase in nasal cavity and nasopharyngeal dimensions, but not the upper pharyngeal airway. Neither reverse-pull headgear nor dental extractions were associated with any change in airway dimensions; however, the evidence is limited. Functional appliances may reduce the severity of obstructive sleep apnoea (OSA) in children.

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使用锥束计算机断层扫描（CBCT）评估儿童正畸治疗与上呼吸道变化之间的关系：系统综述。

背景：一些用于儿童的正畸装置与用于治疗成人阻塞性睡眠呼吸暂停的装置有着相似的设计原理。因此，儿童使用的正畸装置除了治疗错颌畸形外，还可能对上气道产生影响：回顾文献，评估正畸治疗对 CBCT 评估的儿童上气道尺寸的影响：在注册协议（PROSPERO CRD42023439056）后，根据 PRISMA 指南，使用多个数据库（PubMed、Scopus、Web of Science 和 Science Direct）对已发表的研究进行了系统的电子检索。纳入标准如下：年龄在 18 岁以下，接受过任何矫治器的正畸治疗，对照组未接受任何治疗或未采取积极的替代治疗，以及使用 CBCT 测量气道。采用 RoB-2 和 ROBINS-I 工具评估偏倚风险和证据质量：初步搜索后共发现 341 项研究。通过对标题和摘要的筛选，确定了 45 篇研究报告供进一步全文分析。筛选过程结束后，共有 23 项研究符合纳入标准。研究干预措施包括功能性矫治器（10 项研究）、快速上颌扩弓术（RME）（9 项研究）、反向拉头套（1 项研究）和 4 颗前磨牙拔除术（3 项研究）。纳入的研究存在中度至高度偏倚风险，证据质量较低：科学证据表明，在儿童中使用功能性矫治器可显著改善上气道容量和收缩，但对鼻腔的影响有限。反拉式头箍能显著增加鼻腔和鼻咽部的尺寸，但对上咽部气道的影响不大。反拉式头套和拔牙都与气道尺寸的变化无关；但证据有限。功能性矫治器可以减轻儿童阻塞性睡眠呼吸暂停（OSA）的严重程度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.